How Hodgkin lymphoma is diagnosed

You should see your GP if you’re worried about possible [symptoms of Hodgkin lymphoma]. They’ll ask about your health and check to see if you have any swollen lymph nodes.

If your GP thinks your symptoms could be caused by lymphoma they will arrange for you to have some tests at hospital. The main test used to diagnose Hodgkin lymphoma is a lymph node biopsy.

This is the most important test to diagnose Hodgkin lymphoma. A doctor will remove all or part of a lymph node during a short operation. You will either have an injection to numb the area (local anaesthetic) or you will be asleep for it (general anaesthetic), depending on where the lymph node is.

The doctor will send the samples to a lab, where a pathologist will check them under a microscope for any abnormal cells. If the pathologist sees a type of cell called Reed-Sternberg cells, this will confirm that you have classic Hodgkin lymphoma.

You usually get the results of a lymph node biopsy within two weeks.

Diagnosing Hodgkin lymphoma can sometimes be difficult because there might not be many Reed Sternberg cells in the biopsy, and they can be hard to identify. If this happens, you might need a further biopsy to confirm the diagnosis.

Read more about what to expect when you have a lymph node biopsy.

If a lymph node biopsy confirms you have Hodgkin lymphoma, you’ll have further tests to check which areas of your body are affected and your general health. This will help your doctor plan your treatment.

You might not have all of the tests below. Your doctor can explain which tests they want you to have, and what they are looking for.

You will usually have some blood tests to check your general health and how well organs like your liver and kidneys are working. You may also have tests for infections such as Human Immunodeficiency Virus (HIV), hepatitis B and hepatitis C.

Some people have a chest x-ray to check if they have swollen lymph nodes in their chest.

This is a test that uses x-rays and a computer to build a up a picture of the inside of your body. It can be used to see which areas of your body are affected by the Hodgkin lymphoma.

This test combines a CT scan with another type of scan called a PET scan. Before the scan, you have an injection of a small amount of radioactive liquid called a tracer. During the scan, the tracer shows up areas of the body where cells are more active.

A PET-CT scan can show how far the Hodgkin lymphoma has spread and allows your doctor to decide what stage disease you have. You will usually have more PET-CT scans during and at the end of your treatment, to check how well it is working.

An MRI scan is another test that can show how far the Hodgkin lymphoma has spread. It uses magnets and radio waves to create pictures of the inside of your body. You will usually have an MRI instead of a PET-CT scan if you are pregnant.

Rarely, some people may need to have a bone marrow biopsy to check if they have Hodgkin lymphoma cells in their bone marrow. Usually you’ll only need one if you can’t have a PET-CT scan, as this scan can usually show if your bone marrow is affected.

Read more about scans and tests for blood cancer.